An Update on Current Resuscitation Council (UK) Guidelines.

On 15 October 2015, The Resuscitation Council (UK) published new resuscitation guidelines following the review of resuscitation science by the International Liaison Committee on Resuscitation (ILCOR). The 2015 guidelines emphasize the importance of interactions between the emergency medical dispatcher, the bystander who provides cardiopulmonary resuscitation (CPR) and the prompt deployment of an automated external defibrillator (AED); the co-ordination of these three elements is crucial to improving out-of-hospital cardiac arrest survival. Medical emergencies in dental practices are thought to occur on average once every 3−4 years per dentist in primary care. The GDC consider medical emergencies as a highly recommended topic for Continuing Professional Development (CPD) and recommend at least 10 hours in every CPD cycle. Clinical relevance: The publication of the updated guidelines serves as a reminder to the clinical team of the importance of being up to date with recognition and treatment of cardiac arrest and choking and how seamless interaction between members of both the dental and medical teams improves long-term outcomes for patients

Randomised controlled trial of health assessments for older Australian veterans and war widows

The document attached has been archived with permission from the editor of the Medical Journal of Australia (09 January 2008). An external link to the publisher’s copy is included.Objective: To assess the effect of home-based health assessments for older Australians on health-related quality of life, hospital and nursing home admissions, and death. Design: Randomised controlled trial of the effect of health assessments over 3 years. Participants and setting: 1569 community-living veterans and war widows receiving full benefits from the Department of Veterans’ Affairs and aged 70 years or over were randomly selected in 1997 from 10 regions of New South Wales and Queensland and randomly allocated to receive either usual care (n = 627) or health assessments (n = 942). Intervention: Annual or 6-monthly home-based health assessments by health professionals, with telephone follow-up, and written report to a nominated general practitioner. Main outcome measures: Differences in health-related quality of life, admission to hospital and nursing home, and death over 3 years of follow-up. Results: 3-year follow-up interviews were conducted for 1031 participants. Intervention-group participants who remained in the study reported higher quality of life than control-group participants (difference in Physical Component Summary score, 0.90; 95% CI, 0.05–1.76; difference in Mental Component Summary score, 1.36; 95% CI, 0.40–2.32). There was no significant difference in the probability of hospital admission or death between intervention and control groups over the study period. Significantly more participants in the intervention group were admitted to nursing homes compared with the control group (30 v 7; P < 0.01). Conclusions: Health assessments for older people may have small positive effects on quality of life for those who remain resident in the community, but do not prevent deaths. Assessments may increase the probability of nursing-home placement.Julie E Byles, Meredith Tavener, Rachel L O’Connell, Balakrishnan R Nair, Nick H Higginbotham, Claire L Jackson, Mary E McKernon, Lyn Francis, Richard F Heller, Jonathan W Newbury, John E Marley and Brendan G Goodge

Is it time to include the practice nurse in integrated primary health care?

Background: The new '700 series' Medical Benefit Schedule (MBS) items for general practice introduce greatly increased potential for collaboration between general practitioners and other health professionals in patient care. Aim: To investigate the current perceptions of Australian GPs with respect to the desirability and impact of 'sharing care' with nurses and other health professionals. Method: Survey of a sample of GPs in Queensland and NSW participating in the Department of Veterans' Affairs Preventive Care Trial. Results: Fifty-two percent of GPs surveyed worked in a practice where a nurse was employed. The main role of the practice nurse was to do electrocardiograms, apply dressings, and triage duties. Practice nurses played only a minor role in health promotion and education. Seventy percent of GPs identified 'cost' and 58% 'lack of a Medicare item' as the major disincentives to the employment of a practice nurse. Seventy percent of GPs were satisfied with the level of communication with community based health professionals outside the practice, with 'time' nominated as the greatest barrier to optimal contact. Eighty-two percent of GPs considered other health professionals had a role in conducting preventive home visits for the older population, with 70% of GPs identifying that these health professionals had the potential to identify additional health problems, previously unaddressed. Conclusion: Study findings demonstrate an acceptance by GPs of the nurses role and other health professionals in integrated patient care. Funding is seen as the major impediment to the greater utilisation of practice nurses in the general practice setting

Shifting Securities in Northern Ireland: 'Terror' and the Troubles' in global media and local memory

Drawing on interviews conducted between September 2004 and April 2006, this article examines the interaction between percpetions of security generated within Northern ireland and those shaped by the international media concerning global terrorism post 9/11. It offers insights into a society where security concerns are shifting from lareg-scale political violence to the consequences of social separation and paramilitary-related criminality. It argues that the local conflict provides frames which shape attitudes to the media (typologically and sceptically), and that Northern Irish society sheds light on the effects of long-term exposure to heightened security concerns and transnational media

Use of the Family Interaction Macro-coding System with Families of Adolescents: Psychometric Properties Among Pediatric and Healthy Populations

Objective To examine reliability and validity data for the Family Interaction Macro-coding System (FIMS) with adolescents with spina bifida (SB), adolescents with type 1 diabetes mellitus (T1DM), and healthy adolescents and their families. Methods Sixty-eight families of children with SB, 58 families of adolescents with T1DM, and 68 families in a healthy comparison group completed family interaction tasks and self-report questionnaires. Trained coders rated family interactions using the FIMS. Results Acceptable interrater and scale reliabilities were obtained for FIMS items and subscales. Observed FIMS parental acceptance, parental behavioral control, parental psychological control, family cohesion, and family conflict scores demonstrated convergent validity with conceptually similar self-report measures. Conclusions Preliminary evidence supports the use of the FIMS with families of youths with SB and T1DM and healthy youths. Future research on overall family functioning may be enhanced by use of the FIMS

Medical Adherence in Young Adolescents with Spina Bifida: Longitudinal Associations with Family Functioning

Objective The purpose of this study was 2-fold: (1) to explore the transfer of responsibility of medical tasks from parent to child during the transition to adolescence, and (2) to examine the associations between family functioning and medical adherence in youth with spina bifida. Methods Seventy families of children with spina bifida participated in this study. Data were collected during family interaction sessions by using questionnaires completed by mothers, fathers, youth, teachers and health professionals. Results Findings suggest that responsibility for medical regimens transfers gradually from parent to child over time. Additionally, family conflict and cohesion were correlated with medical adherence. Finally, family conflict over medical issues was related to a decrease in medical adherence over time. Conclusions Results suggest that as youth take more responsibility over their medical regimens, family conflict regarding medical issues becomes a contributor to their adherence behaviors. Interventions that target family conflict may facilitate adherence behaviors

Emerging musicality during the pre-school years: a case study of one child

Studies of communication in early infancy and childhood have highlighted the significance of rhythm, sound and music for emotional and social development. There is, however, little detailed empirical data on the emergence of naturalistic music-related behaviour by children in the early years. The aim of this work is to examine instances of musicality with respect to their form and/or function and to trace out developmental indices of musically related behaviours and competencies. Employing a single-case study approach, this paper documents the emergence of one child's musicality between the ages of 1 year, and 3 years 10 months. From a data corpus of video-recordings, 33 examples of musicality, representing 20 time periods, were examined and categorized. In order to examine specific instances, ethnomethodologically informed conversation analysis was used to consider examples in more detail. Beyond indicating what conversation analysis might bring to the study of musical behaviour in context, the results highlight certain interrelationships between musicality, early word use, interpersonal skill and narrative development. Distinct phases-social- affective followed by 'song-word' play and finally narrative-related musicality - were identified in the data. Concluding comments touch on the significance of emerging musicality for social and cognitive development